Thursday, November 9, 2017

Ketones and body composition improvement

Well, here we are again.  Keto diets have made their way back around to incredible popularity and are all the rage once again.

For those not in the know, keto diets are not new, and bacon isn't the new black.  Keto diets have been around since before Twinkies were invented.  That's not entirely a joke.  Twinkies were invented in 1930, and keto diets were being used to treat epilepsy back in the 1920's.

Wait a it possible that Continental Baking Company  invented twinkies as the evil villains weapon in order to thwart the Mayo Clinic from stopping epileptic seizures? 

Keto's ultimate nemesis 

Patient - "I can't eat that, I'm keto.  Keto has stopped my seizures."

Continental Baking Company Dastardly Villain shoves twinkie into patient's mouth.

Patient - "Oh good God, what is that?????"

Continental Baking Company Dastardly Villain - "You like it, yes?"

Patient - "It's heavenly!"

Continental Baking Company Dastardly Villain - "You want more?"

Patient - "Yes I want more.  It's definitely worth a seizure!"

I bet this happened.

Anyways, keto diets are not new, and aren't even new for people trying to shed fat, or potentially use it as a way to improve body composition.  Lots of bodybuilders used keto diets to get shredded for the stage back in the day, and there's been a bit of a resurgence in that lately as well.

Let me state unequivocally here, I don't keto.  And there's a huge misconception that keto diets hold some kind of advantage over other "types" of diets that are sound in nutritional approach when it comes to achieving better body composition.  But that's not the case.

It is generally believed that because of the way endogenous (inside the body) ketones are created that it means fat oxidation is higher in keto or low carb diets.  And technically this is true.  But people need to understand how to interpret this correctly in order to understand it.

If you're eating high fat and low carb, then eventually there's a metabolic shift so that your body becomes more efficient at using fat for energy.  If you throw carbs back in, guess what happens?  You start using glucose for energy again because it's easier to access as fuel for the body.

"AH HAH!  See, you just wrote that eating fat burns fat!"

Yes, but it is due to a lack of carbohydrates being available.  To simplify this even more....

3,500 calories high fat/low carb = the body is using the fats as the main fuel source

3,500 calories higher carb/lower fat = the body is using glucose as the main fuel source

3,500 calories is still 3,500 calories.  (yes, food selection does matter as well).

I'm oversimplifying this but that's the high level overview.

If you stop and think about that, you'll realize that it's carbs that dictate the fuel selection source for the body.  In the absence of carbs, the body will have a metabolic fuel shift to fat.  When carbs are thrown back in, it will have a metabolic fuel shift to glucose again.

I'm not going to drill down into a million areas here because that's not the focus of this article.  I could even make the case due to the fact that fat has the lowest thermic digestion rate of all three macros, that the higher fat diet burns fewer calories each day than the higher carb diet, and that the higher carb diet contains food higher on the satiation index, but that would be a lot of typing that my fingers have no desire to engage in.

I don't have anything against keto diets at all.  I don't think most of the smart people in-the-know do either.  I think it's the misinformation about keto diets that get under their skin.  You cannot just go eating 10,000 calories a day of bacon and butter and be in some blistering state of fat loss "because keto".  I'm sorry, energy in vs energy out is still going to dictate your degree of fat loss or fat gain.

But some people do love eating keto, and can and have achieved magnificent improvements in body comp using keto, because they found it to be a sustainable paradigm of eating for them.  And sustainability in any sound nutritional plan is really the most important aspect.  If you cannot stick with a particular diet or eating lifestyle, then no matter how amazing it looks on paper or in research, it's not going to do you a lot of good.

"How do I fit twinkies into that paradigm, Paul?"


"Thank you!"

With that said, enter exogenous ketones.  I've written several other pieces on them and the anecdotal evidence I've seen with them has been very promising on a number of levels.  The main one being their ability to improve body composition.  And I define an improvement in body composition as the ability to gain or retain muscle while fat loss occurs.  I mean, at the most basic level that's what most everyone who is training to improve their physique is after, right?

More muscle, less fat.

This is what gives women real curves.  More muscle, less fat.  The kind you find on women that squat, deadlift, lunge, and pay attention to the quality of food that they fill their plate with.

More muscle, less fat is what gives doods rock hard abs and big shoulders.  You've never seen a single romance novel where a guy rocking a 40" waist and man boobs was holding the damsel in ovulation distress.  Because guys with beer guts and man boobs don't put women into ovulation distress.  Women want to read a story about how she peeled the shirt off of his muscular torso in the kitchen while they danced on rose pedals, and then took her to pound town.  That's what women want to read about.  Not about how they watched NASCAR while pounding a greasy bucket of Kentucky Fried Chicken.

Where was I?  Oh yeah, improving body composition.  I got hot and bothered there for a minute.

The three things I've really settled for improvement in body composition are a high degree of fat oxidation - which is obtained by being in an energy deficit either through diet, training, or a combination of both (usually the latter).  A high degree of muscle retention or muscle gain.  Muscle retention is what those who have already put in the time building muscle will be seeking, while noobs can actually put on some muscle even while using a hypocaloric diet, or in an energy deficit due to the new stimulus the body is adapting to through lifting weights.

Sound nutrition that is sustainable over a long period of time that creates an energy deficit + weight training + some cardio = the body you're after. 

lift weights, do cardio, drink your ketones, eat all the protein

The last is an improvement in insulin sensitivity.  The reason why this is important is because insulin is your storage hormone, and because it also has exceptionally powerful anti-catabolic properties.  Insulin blunts or reduces muscle protein breakdown.  And if you want to hold on to muscle and keep excess fat storage to a minimum, then it's important to improve insulin sensitivity.

So let's get to it...

Fat oxidation -

Regardless of what type of diet you settle on, in order to burn more fat, you're going to have to be in a calorie deficit.  Let me be clear about something here that you may not know.  Exercise does not burn a lot of calories.  It really doesn't.  You can use the Google machine if you like to go find this out.

In comparative fashion, doing an hour of walking (all depending on how fast you walk, how much you weigh, how much muscle you have or don't have) can be undone rather easily by a few Krispy Kremes.  Trying to achieve a high degree of energy loss (fat loss) through exercise is a great way to get really tired, make yourself super hungry (making it harder to stick to ANY diet), and deplete your motivation.

So lemme make this easy for you.

You lift weights to build muscle.  You do some cardio for your heart, and as a supplemental form of creating energy debt.  Remember, supplemental.  Don't believe for a minute that your hour of (insert type of exercise here) is going to burn enough calories to offset even a single calorie dense meal.

The people who believe they can out train a bad diet usually find that they can't do that for very long before the Continental Baking Company Dastardly Villain shows up, and they are smashing through boxes of Twinkie's faster than Sherman went through Atlanta.

So delicious.

So let's say that you pick out the diet that fits "you".  Keto, Paleo, Southbeach, IIFYM, whatever.  You know (yes YOU KNOW NOW) that you have to be in a calorie deficit with your diet in order to shed that blubber.

One of the biggest keys in finding sustainability with any eating plan is the satiation factor.  If you're hungry all the time, then it becomes harder and harder to sustain an energy deficit with the diet because of binge eating or "falling off the wagon".

The key to this suppressing your hunger hormone, ghrelin.

This actually does lead me back into talking about ketones.

If there is one advantage that keto diets have over other diets when it comes to fat loss, it's that they do a better job of suppressing the ghrelin hormone, so that you have a higher degree of satiation.

Well, as you'd sort of expect, exogenous ketones do the same thing.  As this study points out...



KE consumption increased blood BHB levels from 0.2 to 3.3 mM after 60 minutes. DEXT consumption increased plasma glucose levels between 30 and 60 minutes. Postprandial plasma insulin, ghrelin, GLP-1, and PYY levels were significantly lower 2 to 4 hours after KE consumption, compared with DEXT consumption. Temporally related to the observed suppression of ghrelin, reported hunger and desire to eat were also significantly suppressed 1.5 hours after consumption of KE, compared with consumption of DEXT.


Increased blood ketone levels may directly suppress appetite, as KE drinks lowered plasma ghrelin levels, perceived hunger, and desire to eat.

If you find the biggest culprit in your desire to shed bodyfat is that you are an emotional eater, or have trouble dealing with hunger, then using exogenous ketones offers a massive benefit in that regard.

But that's not all.  There's more.

While this study showed an reduction of power output in cyclists who used ketones, it did show that fat oxidation was higher in those that used ketones prior to exercising.

Total fat oxidation was greater in the ketone versus control (p = 0.05). Average time-trial power output was ∼7% lower (-16 W, p = 0.029) in the ketone condition. Ingestion of ketone salts prior to exercise increases fat oxidation during steady-state exercise but impairs high-intensity exercise performance.

My thoughts about the reduction in power output is that I think we need to work to find the proper dose-response ratio over a number of studies to get clearer picture here.  Because there have been other studies that showed an increase in performance, and there's also a ton of anecdotal testimonies where athletes did improve their performance with them.  Nevertheless, if we're talking fat oxidation/ fat-loss, then using ketones prior to steady state type exercise offers an advantage in that area.

Muscle sparing/retention -

I gots no study for this one, but over the last two years, everything I've hypothesized about with my own reading and work with exogenous ketones has come to fruition.  So I believe this will eventually pan out.  Just a second there to toot my own horn.

Ok, I'm done.

This one should make sense if you follow along.

If you're using a low carb approach to achieve your energy deficit, and are trying to retain muscle, (you should be, duh) one of the issues is that due to low glucose stores, your body will end up creating glucose from protein through something called gluconeogenesis.  This is where you end up robbing Peter to pay Paul, more or less.

What we've seen with exogenous ketones is that there is a reduction in glucose oxidation (using glucose for fuel) while an alternative energy substrate is present (the ketones) and that the ingestion of them (the ketones, again) induces hyperketonemia, which is an elevation of ketone bodies in the blood and body.  Wait...that sounds like ketosis....without a keto diet.

Reduction in glucose oxidation...elevation in ketone bodies in the blood.  Mmmmm that sounds an awful lot like being in ketosis.

Knowing that, what I believe is this - if you're using a low carb approach to find your caloric deficit, and weight training to retain muscle, then the use of ketones will spare muscle protein because the body won't be tapping into it to convert it to glucose.  That's my theory and I'm sticking to it.

Insulin sensitivity -

This is an area where the use of ketones ends up offering a benefit as a side effect of something else.

That sentence makes so much sense, I know.  But bear with me.  I'm actually going to make this quite simple.

BHB reduces inflammation.  I've covered that before, but here, here, here.

Our findings suggest that the anti-inflammatory effects of caloric restriction or ketogenic diets may be linked to BHB-mediated inhibition of the NLRP3 inflammasome.

These findings demonstrate that BHB exerts antidepressant-like effects, possibly by inhibiting NLRP3-induced neuro-inflammation in the hippocampus, and that BHB may be a novel therapeutic candidate for the treatment of stress-related mood disorders.

Now that we've established that BHB serves as an anti-inflammatory agent, let's understand how chronic inflammation effects insulin sensitivity.  

First off, losing fat in general should decrease chronic inflammation in the body, and decreasing excess adipose tissue should improve your insulin sensitivity.  Weight training also improves your insulin sensitivity as well.  

But reducing chronic inflammation will not only improve your quality of health, it should also improve your insulin sensitivity as well.  

Also, linky dinky........

"If we can block or disarm this macrophage inflammatory pathway in humans, we could interrupt the cascade that leads to insulin resistance and diabetes," said Olefsky.

If you want to use the Google machine you can find a metric butt ton of information connecting the dots of chronic inflammation to a key factor in insulin resistance and type 2 diabetes.  

Now let me be clear........

This doesn't mean you can drink ketones and expect miracles.  If you're not reducing the amount of Omega-6 coming in and increase your Omega-3 and also lifting weights and doing some conditioning, it's fool hearty to believe that simply ingesting ketones is going to magically fix your problems.  They won't.  But they can play a major role in accelerating the reduction of chronic inflammation in the body, they can improve the degree of fat oxidation during steady state exercise, and they can suppress the appetite, making it easier to stay in your caloric deficit.  All things that will lead to a significant improvement in body composition, and land you on the cover of a romance novel.  

Ok, probably not.  You're not that good looking.  But looking better naked tends to make you and anyone seeing you naked much happier.  

Try them at

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